Abstract
Purpose :
To determine the frequency of intravitreal silicone oil droplets (SOD) in patients who have been treated with bevacizumab (Bev) in BD syringes and also assess the symptomatic impact.
Methods :
An institutional review board (IRB) determined this prospective observational double-blind study was exempt from IRB approval. Consecutive returning patients with a minimum of 1 prior Bev injection were closely examined for the presence of SOD. Following the exam, a retrospective chart review was performed to determine the type of Bev syringe used previously and to divide the patients into 2 groups, normject syringe only (NJ) as control group, or normject and BD syringes (BD) as the test group. Other data recorded included: age, sex, number of injections, dates of first and last injection, underlying diagnosis, and examining physician.
All patients were also queried at the exam for a response regarding increased symptomatic floaters since starting injections with the following possible responses: A) clear circles with black outline. B) webs, strings, or bugs. C) circles that disappear in 2-3 days following injection. D) none of the above.
Data was analyzed as percents with 95% confidence intervals (CI) using modified Wald method, and p values of statistical significance by Fischer’s exact testing to compare proportions.
Results :
A total of 426 consecutive patients that received prior intravitreal Bev injections were examined in this study. There were 51 NJ patients and 375 BD patients. The mean (M) age, standard deviation (SD), percent male, M number of injections, M course of treatment in months, for NJ and BD respectively were: M age 70.67 (SD)+/-15.414, 39.2% male, M injections 2.08 +/- 1.707, M course 5.59 +/- 19.6 months versus M age 76.47 +/-11.069, 40.0% male, M injections 7.68 +/- 7.642, M course 17.56 +/- 20.275 months. Oil bubbles were reported on clinical exam at rates of 7.8% and 67.2% for NJ and BD groups respectively (p < 0.001, CI 2.58- 19.01%; 62.29- 71.76%). The floater responses consistent with SOD (response A) was for NJ and BD 2.0% vs. 10.4% (p = 0.069, CI 0.01- 11.27%; 7.68- 13.93%).
Conclusions :
There appears to be a statistically significant number of patients with SOD following the use of BD syringes and a close to significant patient response for floaters consistent with SOD.
This is a 2020 ARVO Annual Meeting abstract.